5 Baltimore School Clinics To Offer Students Norplant

Public-health and school officials in Baltimore announced last week
that they will begin offering Norplant, the surgically implanted
contraceptive, in two more high school health clinics next month and in
three others next spring.

The Baltimore city school system last January became the first
district in the nation to offer the long-term contraceptive to its
students when it opened a pilot program at a high school for girls who
are pregnant or who have had children. (See Education Week, Dec. 16,
1992.)

The five clinics slated to be included in the expansion of the
program are all in regular high schools.

"There are huge teenage-pregnancy problems in all these high
schools, and offering options is one of the minimal things we can do,''
said Elizabeth S. Miola, the director of the city's school-based-clinic
program.

In Baltimore, 97 out of every 1,000 girls between ages 15 and 17
gave birth in 1990, a rate that is three times the statewide average,
according to local health officials.

Last year, the city school board authorized that Norplant be offered
along with such already available birth-control choices as condoms,
diaphragms, and oral contraceptives in public school clinics.

Norplant consists of six matchstick-sized capsules that are
implanted in a woman's upper arm. The capsules release a hormone that
will prevent ovulation for up to five years.

Some Opposition

The decision to increase the number of Baltimore schools that offer
Norplant has sparked opposition from some local leaders. The district
does not require parental notification or consent before dispensing
contraceptives, including Norplant, to minors, and some city leaders
fear parents will be excluded from the process.

"The health department has decided they want to do surgery on girls
without parental consultation,'' said Karl Stokes, a city councilman
who has opposed the program from its inception.

But Dr. Peter Beilenson, Baltimore's health commissioner, said
students there are "very well-informed about the procedure'' and that
three counseling sessions are conducted before the device is
inserted.

Mr. Stokes and others also contend that Norplant will make teenagers
less likely to practice "safe sex,'' thus putting them at an increased
risk for contracting AIDS and other sexually transmitted diseases. City
health officials said they recognize this hazard and noted that clinic
workers provide free condoms to students.

Critics elsewhere also argue there has not been sufficient research
on the effect of Norplant on the health of adolescents who use it.

But one high school principal involved in the Baltimore program's
expansion said he is pleased he will soon be able to provide another
choice for his students.

"The teenage-pregnancy problem is a serious problem here,'' said
Principal David M. Benson of Southwestern High School. He estimated
that of the 1,600 students at his school, 200 are teenage parents. The
more birth-control choices these students have, he said, the
better.

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